This revolution will not be Uberized

This revolution will not be Uberized

There are a lot of really amazing one-off mobile use cases that have been developed. For me, as a practical person who finds it hard to not deal with the reality that most healthcare centers have a burden of legacy technologies and contracts that are not going to be thrown out just because there is some shiny and new. (I have a blog about my view on where healthcare will be in five years)

What has struck me is how much of the success of the mobile health apps talked about had nothing to do with the current buzzword around healthcare; on-demand, concierge mobile care - i.e. the Uberization of healthcare.

For the most part the core lessons learned was that the successful projects relied on technology to reduce workload to either patients or care team members as a whole. Many of them worked because they provided a long term easy to use experience rather than a series of one-off disconnected "touchpoints." The successes also emphasized the requirement that solutions work for the whole spectrum of care not just the "franchise player."

The need for a team-based care protocol is why I do not think we should waste anymore time or effort in Uberization. To me the key reason Uber is not a good mode for where we need to take healthcare is I do not expect a relationship with the Uber driver. I want it on-time at-cost and professional from the car service (before you attack that is not to say Uber is bad, it just isn't a model for long term success in the healthcare industry). Time and time again we are reminded that in healthcare in is a continuum of care from home care, hospital to primary physician that is both the individual need and the most efficient long term framework. This is how we reduce the key measurables in healthcare patient readmissions, test per patient, cost of medication per patient.

Let's start with a blanket statement. Technology will not be the savior of healthcare....I get it Watson is going to make decisions easier and telehealth will bring doctors into your house. But is that what the average patient wants? We cannot reinvent healthcare by just de-personalizing it. We know that there cases where patients, such as palliative care like the convience of being home but I know when my son was short of breath and gagging I am not looking to be fiddling with my phone and hoping for the best. I WANT a doctor and nurse I want care for my sick loved one that I can't give.

At the end of the day healthcare requires a team that talks, touches and listens to a person who is hurt, scared and unsure. Not to be paternalistic but the reality is the average person is neither interested or equipped to "own their healthcare" they need a trusted source that will walk them through their care.

The goal of mobile in healthcare should not be to mobilize/Uberize/transform healthcare. It should be to get administrative BS and mundane process out of the way of all parts of the care team so that patients are the focal point not the technology.

Whether we call it personalized medicine or patient centered medicine we should not be thinking technological hurdles first. It is why most EMR implementations are a disaster, they were deployed with no forethought as to what care is and what is should be. The arrogance of most of the large EMR vendors is that they assume that they know how doctors work (and quite often they don't even bother to acknowledge the role of nurses and pharmicists).